• Title/Summary/Keyword: Injections

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Study of the Difference in Residual Amounts according to the Method of Securing Intravenous Injections and the Dose of Physiological Saline during 18F-FDG Administration (18F-FDG 투여 시 정맥주사 확보 방법 및 생리식염수 용량에 따른 잔류량의 차이에 관한 연구)

  • Ryu, Chan-Ju
    • Journal of the Korean Society of Radiology
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    • v.16 no.2
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    • pp.95-102
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    • 2022
  • This study compares the difference between the remaining amount in syringes according to injection method and the dose of physiological saline when the radiopharmaceutical 18F-FDG isotope is injected into patients who visited the hospital for PET examination. After performing a CT or MRI using a contrast medium when 18F-FDG was injected into 40 patients who came to the hospital for PET examination without removing the 3-way, the radioactivity remaining in the syringe and the 3-way was measured and the dose of radioactivity confirmed. At this time, 20 patients were divided into different dose groups of physiological saline. Another injection method was used to compare the remaining amount of the syringe and the difference in the remaining amount according to the amount of physiological saline when the injection was performed with an extension. After an injection of 18F-FDG, the actual administered dose was confirmed by measuring the radioactivity remaining in the syringe and the 3-way or extension with a calibrator. As a result of measuring the radioactivity of the syringe before administering the radiopharmaceutical and the radioactivity of the syringe and the 3-way or extension after administration, the 3-way injection method in 10 cc's of physiological saline had the lowest residual amount. The remaining amount increased in the order of the extension to 10 cc's of saline and the 3-way to 5 cc's of saline. Likewise, the 5 cc's saline solution and the extension injection method demonstrated the highest residual amounts. The residual difference with the lowest level of remaining injection method was found to be 0.053 mCi. It was found that in a PET examination, by considering the radioactivity remaining in the 3-way and extension and by adjusting the dose of physiological saline, if the intended dose to be administered to the actual patient is determined, it is possible to administer the radiopharmaceutical to the patient more accurately.

Clinical Outcomes of Ultrasound-Guided Transmeniscal Injection in Medial Compartment Knee Osteoarthritis (무릎 내측 구획 골관절염에서 초음파 유도하 경 반월상 연골 주사의 임상적 효과)

  • Jung, Eui Yub;Wang, Joon Ho;Lee, Eui-Sub;Lee, Sung-Sahn;So, Sang-Yeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.418-425
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    • 2020
  • Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.

A Study on the Precipitation Mechanism of Quartz Veins from Sangdong Deposit by Analyses of Vein Texture and Trace Element in Quartz (상동광산 석영맥의 조직 및 석영의 미량원소 분석을 통한 광맥 침전 기작 도출)

  • Youseong Lee;Changyun Park;Yeongkyoo Kim
    • Economic and Environmental Geology
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    • v.56 no.3
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    • pp.239-257
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    • 2023
  • Sangdong deposit, a W-Mo skarn deposit, is located in Taebaeksan mineralized district, hosting vertically developed scheelite-quartz veins that formed at the late ore-forming stage. In this study, we tried to examine the geochemical signatures of ore-forming fluids and vein-forming mechanisms by analyzing the micro-texture of quartz veins and trace element concentrations of quartz. As a result of texture analyses, quartz veins in the hanging wall orebody and the foot wall orebody commonly exhibit the blocky and the elongate blocky texture, respectively, whereas quartz veins in the main orebody show both textures. These textural differences indicate that quartz veins from the hanging wall orebody were precipitated by the primary hydrofracturing due to H2O saturation in the igneous body with relatively high temperature and pressure at a vein-skarn stage, and after that, repeated hydrofracturing caused the formation of quartz veins from the main orebody and foot wall orebody. The results of trace element concentrations show that Li++Al3+↔Si4+ is a main substitution mechanism. However, those of the foot wall orebody were clearly divided into a Li+-dominated substitution and a Na+-, K+-dominated substitution. Considering that quartz veins from the foot wall orebody commonly show the elongate blocky texture, such a distinction means that it is a result of repeated injections of fluid with the different composition. Ti concentrations of quartz from the hanging wall, main, and the foot wall orebody are 28.6, 8.2, and 15.7 ppm in average, respectively. Given a proportional relationship between the precipitation temperature and Ti concentrations, it seems that quartz veins from the hanging wall orebody were precipitated at the highest temperature. Al concentrations of the hanging wall, main, and the foot wall orebody having an inverse relationship with fluid pH are 162.3, 114.2, and 182.5 ppm in average, respectively. These results show that Al concentrations in vein-forming fluids were not changed dramatically. Moreover, these concentrations are extremely low in comparison with the other hydrothermal deposits. This indicates that quartz in overall ore veins at Sangdong deposit was precipitated from the constant condition with slightly acidic to near neutral pH.

Studies on the Cryopreservation and Survival after Thawing of Hamster Embryos (Hamster 수정란(受精卵)의 동결보존(凍結保存) 및 생존성(生存性)에 관한 연구(硏究))

  • Oh, Won Jin;Lee, Kyu Seung;Kim, Young Mook
    • Korean Journal of Agricultural Science
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    • v.13 no.1
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    • pp.82-89
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    • 1986
  • This experiment was carried out to determine the optimum freezing and thawing rates of the hamster embryos. The female hamsters were induced to superovulate by intraperitoneal injections of 30 i.u. PMSG and mated with males of the same strain of 4 days the PMSG injection. They were killed and embryos were flushed from the oviduct and uterine horn on 3 days after mating. Embryos were flushed with a modified Dulbecco's phosphate-buffered saline and equilibrated with 1.5 M-dimethylsulphoxide by a 3-step procedure. The freezing rates of the samples were $1^{\circ}C/min$ from room temperature to $-6^{\circ}C$ and the samples were seeded at $-6^{\circ}C$. After being held for 3 min at the seeding temperature, the rates were $0.3^{\circ}C/min$ from $-6^{\circ}C$ to $-35^{\circ}C$. From $-35^{\circ}C$ to $-70^{\circ}C$, the rates were divided into $0.1^{\circ}C/min$, $1^{\circ}C/min$ and $10^{\circ}C/min$, respectively. At $-70^{\circ}C$ the samples were plunged directly into liquid nitrogen. The samples were thawed at $4^{\circ}C/min$ and $12^{\circ}C/min$ from $-196^{\circ}C$ to $37^{\circ}C$, and for 2 min in $37^{\circ}C$ water bath, respectively. The average numbers of ovulation points and embryos recovered were 35.1 and 27.0 appearing 77.0% recovery rates. Eight cell embryos in the embryos recovered were 24.8. The survival rates of embryos according to the freezing rates were 55.5~67.7% at $0.1^{\circ}C/min$, 58.8~64.9% at $1^{\circ}C/min$ and 40.5~44.7% at $10^{\circ}C/min$, respectively. The survival rates at $10^{\circ}C/min$ were significantly low. The survival rates of embryos according to the thawing rates were 53.5% at $4^{\circ}C/min$, 53.7% at $12^{\circ}C/min$ and 59.1% in $37^{\circ}C$ water bath. The survival rates, in $37^{\circ}C$ water bath were slightly higher, but we did not find any differences among them. In conclusion, the best freezing rates of hamster embryos were $1^{\circ}C/min$ from the room temperature to $-6^{\circ}C/min$, $0.3^{\circ}C/min$ from $-6^{\circ}C/min$ to $-35^{\circ}C$ and $-0.1^{\circ}C/min$ or $1^{\circ}C/min$ from $-35^{\circ}C$ to $-70^{\circ}C$. The hamster embryos thawed for 2 min in $37^{\circ}C$ water bath showed the best survival rates.

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The Study of Radiation Reducing Method during Injection Radiopharmaceuticals (방사성의약품 투여 시 피폭선량 저감에 대한 연구)

  • Cho, Seok-Won;Jung, Seok;Park, June-Young;Oh, Shin-Hyun;NamKoong, Hyuk;Oh, Ki-Beak;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.80-85
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    • 2012
  • Purpose: The whole body bone scan is an examination that visualizing physiological change of bones and using bone-congenial radiopharmaceutical. The patients are intravenous injected radiopharmaceutical which labeled with radioactive isotope ($^{99m}Tc$) emitting 140 keV gammarays and scanned after injection. The 3 principles of radiation protection from external exposureare time, distance and shielding. On the 3 principles of radiation protection basis, radiopharmaceutical might just as well be injected rapidly for reducing radiation because it might be the unopened radiation source. However the radiopharmaceuticals are injected into patient directly and there is a limitation of distance control. This study confirmed the change of radiation exposure as change of distance from radiopharmaceutical and observed the change of radiation exposure afte rsetting a shelter for help to control radio-technician's exposure. Materials & methods: For calculate the average of injection time, the trained injector measured the injection time for 50 times and calculated the average (2 minutes). We made a source as filled the 99mTc-HDP 925 MBq 0.2 mL in a 1 mL syringe and measured the radiation exposure from 50 cm,100 cm,150 cm and 200 cm by using Geiger-Mueller counter (FH-40, Thermo Scientific, USA). Then we settled a lead shielding (lead equivalent 6 mm) from the source 25 cm distance and measured the radiation exposure from 50 cm distance. For verify the reproducibility, the measurement was done among 20 times. The correlation between before and after shielding was verified by using SPSS (ver. 18) as paired t-test. Results: The radiation doses according to distance during 2 minutes from the source without shielding were $1.986{\pm}0.052{\mu}$ Sv in 50 cm, $0.515{\pm}0.022{\mu}$ Sv in 100 cm, $0.251{\pm}0.012{\mu}$ Sv in 150 cm, $0.148{\pm}0.006{\mu}$ Sv in 200 cm. After setting the shielding, the radiation dose was $0.035{\pm}0.003{\mu}$ Sv. Therefore, there was a statistical significant difference between the radiation doses with shielding and without shielding ($p$<0.001). Conclusion: Because the great importance of whole body bone scan in the nuclear medicine, we should make an effort to reduce radiation exposure during radiopharmaceutical injections by referring the principles of radiation protection from external exposure. However there is a limitation of distance for direct injection and time for patients having attenuated tubules. We confirmed the reduction of radiation exposure by increasing distance. In case of setting shield from source 25 cm away, we confirmed reducing of radiation exposure. Therefore it would be better for reducing of radiation exposure to using shield during radiopharmaceutical injection.

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GET Imaging Evaluation of Patients with Esophageal Cancer (식도암 환자의 GET 영상 평가)

  • Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.31-36
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    • 2013
  • Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.

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Therapeutic Angiogenesis by Intramyocardial Injection of pCK-VEGF165 in Pigs (돼지에서 pCK-VEGF165의 심근내 주입에 의한 치료적 혈관조성)

  • Choi Jae-Sung;Han Woong;Kim Dong Sik;Park Jin Sik;Lee Jong Jin;Lee Dong Soo;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.323-334
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    • 2005
  • Background: Gene therapy is a new and promising option for the treatment of severe myocardial ischemia by therapeutic angiogenesis. The goal of this study was to elucidate the efficacy of therapeutic angiogenesis by using VEGF165 in large animals. Material and Method: Twenty-one pigs that underwent ligation of the distal left anterior descending coronary artery were randomly allocated to one of two treatments: intramyocardial injection of pCK-VEGF (VEGF) or intramyocardial injection of pCK-Null (Control). Injections were administered 30 days after ligation. Seven pigs died during the trial, but eight pigs from VEGF and six from Control survived. Echo-cardiography was performed on day 0 (preoperative) and on days 30 and 60 following coronary ligation. Gated myocardial single photon emission computed tomography imaging (SPECT) with $^{99m}Tc-labeled$ sestamibi was performed on days 30 and 60. Myocardial perfusion was assessed from the uptake of $^{99m}Tc-labeled$ sestamibi at rest. Global and regional myocardial function as well as post-infarction left ventricular remodeling were assessed from segmental wall thickening; left ventricular ejection fraction (EF); end systolic volume (ESV); and end diastolic volume (EDV) using gated SPECT and echocardiography. Myocardium of the ischemic border zone into which pCK plasmid vector had been injected was also sampled to assess micro-capillary density. Result: Micro-capillary density was significantly higher in the VEGF than in Control ($386\pm110/mm^{2}\;vs.\;291\pm127/mm^{2};\;p<0.001$). Segmental perfusion increased significantly from day 30 to day 60 after intramyocardial injection of plasmid vector in VEGF ($48.4\pm15.2\%\;vs.\;53.8\pm19.6\%;\;p<0.001$), while no significant change was observed in the Control ($45.1\pm17.0\%\;vs.\;43.4\pm17.7\%;\;p=0.186$). This resulted in a significant difference in the percentage changes between the two groups ($11.4\pm27.0\%\;increase\;vs.\;2.7\pm19.0\%\;decrease;\;p=0.003$). Segmental wall thickening increased significantly from day 30 to day 60 in both groups; the increments did not differ between groups. ESV measured using echocardiography increased significantly from day 0 to day 30 in VEGF ($22.9\pm9.9\;mL\;vs.\;32.3\pm9.1\;mL;\; p=0.006$) and in Control ($26.3\pm12.0\;mL\;vs.\;36.8\pm9.7\;mL;\;p=0.046$). EF decreased significantly in VEGF ($52.0\pm7.7\%\;vs.\;46.5\pm7.4\%;\;p=0.004$) and in Control ($48.2\pm9.2\%\;vs.\;41.6\pm10.0\%;\;p=0.028$). There was no significant change in EDV. The interval changes (days $30\~60$) of EF, ESV, and EDV did not differ significantly between groups both by gated SPECT and by echocardiography. Conclusion: Intramyocardial injection of pCK-VEGF165 induced therapeutic angiogenesis and improved myocardial perfusion. However, post-infarction remodeling and global myocardial function were not improved.

Immunogenicity and Safety of a Combined Hepatitis B and Haemophilus influenzae Type b Conjugate(PRP-OMP) Vaccine(ComvaxTM; Merck & Co.) in Korean Infants (한국 영아에서 B형 간염과 PRP-OMP의 혼합백신(ComvaxTM; MSD사)의 면역원성 및 안전성)

  • Chung, Eun Hee;Ma, Sang Hyuck;Hong, Young Jin;Kim, Kyung Hyo;Kim, Jong-Hyun;Lee, Jin A;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.163-173
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    • 2006
  • Purpose : To reduce the number of injections necessary to vaccinate young infants, various combined vaccines have been developed. The $Comvax^{TM}$ manufactured by Merck & Co. is a combination of Hepatitis B and PRP-OMP conjugate Haemophilus influenzae Type b vaccine. The purpose of this study is to evaluate the immunogenicity and safety of $Comvax^{TM}$ in Korean infants. Methods : The infants who were vaccinated at 0 months of age with Hepatitis B vaccine, were recruited for this study after parental informed consent was obtained. The subjects were vaccinated with $Comvax^{TM}$ at 2 and 4 months of age. At each visit, infants were also immunized with DTaP, inactivated poliovirus vaccine, and pneumococcal vaccine when indicated. The serum anti-PRP and anti-HBs were measured at 2 months after the 1st dose(4 months age), and the 2nd dose(6 months age) by the ELISA and chemiluminescent microparticle immunoassay method, respectively. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Results : Among sixty-five healthy infants(35 male infants) enrolled in this study; fifty eight(32 male infants) completed the scheduled immunizations. The geometric mean titers (GMTs) of anti-PRP at 2 months after the 1st dose and the 2nd dose were 1.96 ${\mu}g/mL$ (95% CI; 1.38~2.78) and 10.02 ${\mu}g/mL$ (95% CI; 7.04~14.26), respectively. Anti-PRP ${\geq}1.0$ ${\mu}g/mL$, was obtained in 63.2%(95% CI; 53.75~72.65) after 1 dose, and 96.6%(95% CI; 93.05~100) after 2 doses. The GMTs of anti-HBs were 38.32 mIU/mL(95% CI; 22.42~65.51), and 101.17 mIU/mL(95% CI; 65.94~155.25) at 2 month after the 1st dose and 2nd dose of $Comvax^{TM}$, respectively. Anti-HBs ${\geq}10$ mIU/mL was observed in 73.7%(95% CI; 65.07~82.33) after 1 dose and 94.8%(95% CI; 90.45~99.15) after 2 doses. Most of the adverse reactions after vaccination were mild. Irritability, the most common systemic reaction, was observed in 24.8%, followed by drowsiness(19.2%), poor feeding(19.2%) and fever(7.2%). Among the local reactions tenderness was observed in 25.6%, redness(${\geq}5$ mm) in 19.2% and swelling(${\geq}5$ mm) in 4.8%. Conclusion : The $Comvax^{TM}$ vaccine was highly immunogenic for PRP and safe in Korean infants. Although the hepatitis B vaccine component was administered at 0, 2, 4 months, this study showed good immunogenicity against HBsAg.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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